To the Editor.—As a pipe smoker who rarely smokes in company, I take some umbrage at Dr Tuteur's rather opinionated reply in the Question and Answers section of a recent issue of JAMA.1 A simple "no hard data exist" would have answered the question more truthfully. To state that "pipe smokers' risk of death due to pulmonary carcinoma is intermediate between those of never smokers and cigarette smokers" stretches the definition of intermediate (which is defined as "lying or being in the middle place or degree," according to Webster's). As Tuteur knows, the risk of pulmonary carcinoma in pipe smokers is much closer to the never smokers and far from the cigarette smokers. Though the degree of inhalation is undoubtedly important, it is unlikely that "all types of tobacco smoke (regardless of source)" are equally dangerous. For reasons not yet elucidated, cigarette smoke is much the greater